Force Science News #207:
New study shines a revealing light on police injuries
A groundbreaking pilot study of more than 9,700 officers, aimed at determining whether it’s feasible to establish a national reporting system for police injuries, has revealed a wealth of intriguing facts about LEOs hurt on duty.
Among the highlights:
• Training exercises were second only to making an arrest as the activity most often engaged in at the time of injury, with in-service training proving especially risky;
• Some 18% of officer injuries posed a risk of “significant external hemorrhage,” putting cops in the 99 percentile of all occupations for this danger;
• Of officers injured in vehicle crashes during emergency responses, more than three-fourths had five years or less on the job;
• Across all activity categories, motorcycle crashes, while among the least common occurrences, produced the highest average of lost work days per incident (28.4);
Perhaps most important long range, according to one of the researchers involved, this preliminary study confirms that with adequate funding a nationwide reporting system for law enforcement injuries, comparable to the FBI’s ongoing LEOKA tally of felonious fatalities, could be put in place, with significant benefits for training and officer safety.
The study was funded by the DOJ’s Bureau of Justice Assistance in a grant to the International Assn. of Chiefs of Police. The project manager and principal investigator was Lt. Adrienne Quigley of the Arlington County (VA) PD, with the well-known SWAT doc and trauma surgeon, Dr. Alexander Eastman, deputy medical director for the Dallas (TX) PD, serving as medical advisor.
Quigley and Eastman presented a summary of findings at the latest IACP annual conference, and Eastman elaborated on them recently during an interview with Force Science News.
DEARTH OF KNOWLEDGE. “One of the biggest problems in making policing safer is that we have very little information on how officers are injured,” Eastman says. “We know how they get killed and we have rough estimates that 110,000 are hurt in a typical year, but we don’t have a good, detailed handle on the types and circumstances of those injuries.”
Learning more, he explains, would help in designing relevant protocol for treating injuries in the field, improving training to reduce the incidence, save officers pain and potential disability, and cut the costs for medical care and lost work days “that can be financially devastating for law enforcement agencies.”
In the IACP presentation, he cited several “large-loss examples,” including an officer who tripped over a chair, causing a ligament tear and fracture, which escalated to costs of $303,000, and another who suffered knee damage while subduing a suspect, to the cumulative tune of $595,000.
Quigley added: “Too often there’s an attitude that injuries are just part of the job. We want to change that and work toward zero tolerance for officer injuries.”
RESEARCH DESIGN. For the pilot study, the first of its kind, 18 state, county, and municipal agencies of various sizes from five scattered states (New York, Oregon, Texas, Minnesota, and Tennessee) agreed to submit detailed information online regarding “any injury resulting in pain or discomfort” sustained on duty by their personnel across a 12-month period.
Among the “ton of data” amassed and analyzed were the demographics of the involved officers (age, gender, rank, experience, assignment); the type and severity of injury; the number of work days lost, if any; the type of call or activity engaged in when injured; and whether the officer was involved in a fitness/wellness program.
INJURY INCIDENCE. In all, 9,746 officers were monitored, with 1,285 injuries (about 13 per 100 officers) reported during the year. One-third of the mishaps required transportation to a hospital, but with only 17 admissions and one death (from a motorcycle crash). Patrol officers, not surprisingly, were the most likely to be hurt.
Nearly half the injuries (47%) consisted of sprains, strains, and soft-tissue tears, followed by contusions (15%), lacerations (14%), and exposure to bloodborne pathogens (7%). Broken bones; chronic injuries to heart, lungs, or back; dislocations; knife puncture or gunshot wounds; and internal damage were relatively rare (3% or less).
The activities most often associated with injury were making arrests (24% of the total), training (13%), automobile crashes (11%), foot pursuits (6%), and slips and falls (6%). Injuries resulting from use of force apart from making an arrest constituted only 4% of the total.
VULNERABILITY EXPLORED. At the IACP conference, Eastman and Quigley identified certain “areas of vulnerability” for more detailed analysis. (Percentages cited are rounded.)
• Fitness & Wellness. Of the officers injured during the year, only 17% received the amount of daily exercise recommended by federal guidelines, although more than half (54%) self-reported that they participated in “some sort” of fitness program. Injuries related to sprains and strains dropped as workout intensity increased.
• Training. More than 2/3 (65%) of training injuries occurred during in-service sessions, with nearly three times the number of lost work days befalling veteran officers compared to academy recruits. DT and physical fitness activities accounted for the majority of injuries, which overwhelmingly were strains and sprains (70%).
The fact that the greatest injury toll occurred during daylight weekday hours may be because of the high number of injuries during training periods, the researchers concluded.
A significant percentage of subjects injured in training did not participate in a regular fitness program nor did they warm up or stretch prior to the training activity. Of those hurt during firearms training, for example, about a third suffered injury during physical exercise to increase their heart rate but “none warmed up or stretched, ” beforehand, the researchers reported.
• Confrontations. Nearly half (49%) of the officers injured effecting an arrest or otherwise using force were relatively new to the job, with one to five years’ experience. Injury rates declined with tenure, dropping sharply after 16 years. In Eastman’s opinion, this may correlate with less risky assignments and/or more savvy tactics with experience.
The injuries in arrest/force situations were most often strains and sprains, followed by lacerations, contusions, and bloodborne pathogen exposure. Disturbance calls (drunk/disorderly, fight, domestic dispute) were the single riskiest category, accounting for about 36% of injuries. Nearly a third of the suspects involved were “impaired by drugs or alcohol,” with an additional 10% having a mental disorder.
Of officers reporting injuries from arrests and use of force, 45% had failed to receive any training in arrest procedures in the previous two years, while about one-third had gone at least two years since their last DT training.
• MV crashes. Time on the job and a training gap seemed to affect the car crash injury rate also, the study suggests. Total crashes and emergency response crashes both were highest during the first five years of service, then dropped sharply after that. And more than half (54%) of the officers injured in crashes had not received any training in vehicle operations within two years of their incident.
“Most crashes were intersection related, followed by loss of control and rear-end collisions,” the study found. The most common injuries were strains and sprains involving neck and back pain.
Most injured officers (82%) were wearing seatbelts and the majority who weren’t were sitting in their vehicle on the side of the road when hit.
• Foot pursuits. Here 65% of officers injured had five years’ or less experience, “with a steady drop in injuries with tenure,” the researchers reported. Within two years before their injury, only 35% of officers hurt had received training in foot pursuit tactics.
Over 40% of injuries generated from in-progress calls (especially burglaries, larcenies, motor vehicle thefts) and investigative enforcement (suspicious subjects, wanted persons). While a majority of injuries were strains and sprains, a significant percentage (36%) of officers hurt in pursuits required transport to the hospital, multiple surgeries, and a high number of days off work. Indeed, while foot pursuits accounted for only about 6% of the total injuries reported, they represented more than 12% of the total work days lost.
Some 82% of harmful pursuits occurred in urban settings and injuries were evenly distributed across lighting conditions. Yet lost work days most often were associated with daylight chases.
• Bloodborne pathogens. At least some up-to-date training seemed most evident among the officers whose injuries involved potential exposure to bloodborne diseases, including AIDS and hepatitis. In the previous year, about 88% had received training on this subject, although fewer than half of those (47%) had gotten instruction specifically on proper search and pat-down techniques.
In all, about 7% of officers were exposed to bloodborne pathogens—63% of those via direct physical contact, 25% through spitting, and 12% from needle sticks.
CONCLUSIONS. Given that the pilot study monitored fewer than 1% of the nation’s sworn LEOs, Eastman stresses that research into officers’ “astronomical” injury risk needs to continue on a broader scale to “better define what’s happening in the field.”
He believes that the study does demonstrate that a national, comprehensive, “real-time” data-gathering system among law enforcement agencies is feasible. “With firefighters, line-of-duty injuries are tracked and trends are analyzed very thoroughly,” he says. “But we don’t have anything like that for police officers, and it is clearly needed. Law enforcement agencies need to be more transparent and to share information when things go wrong and officers are hurt.”
Eastman is part of the DOJ’s Officer Safety and Wellness working group, convened to explore “novel, high-impact programs” in those subject areas, and he’s hopeful that a system for gathering reliable, nationwide statistics may emerge from that effort.
Finally, he believes that the study findings confirm the need for an on-scene medical treatment protocol designed especially for law enforcement. Currently, he points out, police training sometimes pushes the military’s highly successful Tactical Combat Casualty Care (TCCC) procedures for non-medics, which emphasize self-care and buddy-care for control of severe bleeding from extremities, airway clearance, and emergency response to internal chest injury that interferes with breathing (tension pneumothorax).
“Officers’ injuries and their pattern of wounding tend to be much different from battlefield injuries,” Eastman says. “Officers are not dying from having their extremities blown off by an IED, and few experience really significant brain trauma. We need an evidence-based first aid system that specifically addresses the types of injuries we see in policing.”
While the study showed that hemorrhage management needs to be a part of any law enforcement system, other components of TCCC may not be as relevant, he explains. Among the injuries reported in the pilot, none involved airway damage or tension pneumothorax, for example.
In his IACP presentation, Eastman credited Dr. Matthew Sztajnkrycer, an emergency medicine expert at the Mayo Clinic and a Force Science Anaslysis instructor, with being “the first to really question whether the TCCC model is appropriate for law enforcement.”
Now, Eastman told the IACP audience, “we are maturing in law enforcement medicine to the point that we can begin crafting our own easy-to-train, easy-to-use model.”
For more information, Dr. Eastman can be reached at: firstname.lastname@example.org
Written by Force Science Institute
July 1st, 2012 at 1:33 pm
© 2017 Force Science Institute Ltd.